skip to main content

Posterior shoulder dislocation after seizure — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardMusculoskeletal systemPosterior shoulder dislocation after seizureSCE Acute Medicine

After a generalised seizure, a patient holds the arm adducted and internally rotated and cannot externally rotate it. The initial AP film is equivocal. What is the next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Obtain AP and axillary imaging for posterior dislocation

The best answer is “Obtain AP and axillary imaging for posterior dislocation”. This is correct because seizure-associated internal rotation and blocked external rotation are classic, while posterior dislocation is easily missed on AP views. Axillary or scapular-Y imaging confirms alignment before reduction. Assuming an anterior injury or manipulating without diagnosis can cause fracture and neurovascular harm.

Reference: NICE NG38 fracture and major-trauma assessment recommendations: https://www.nice.org.uk/guidance/ng38/chapter/Recommendations